scholarly journals Two-stage reconstruction for flexor tendon injuries in zone II using a silicone rod and pedicled sublimis tendon graft

2010 ◽  
Vol 43 (01) ◽  
pp. 014-020
Author(s):  
Mohammed Heshmat Abdul-Kader ◽  
Mahmound A. M. Amin

ABSTRACTWe report the results of staged flexor tendon reconstruction in 12 patients (12 fingers) with neglected or failed primary repair of flexor tendon injuries in zone II. Injuries involved both flexor digitorum profundus (FDP) and flexor digitorum sublimis (FDS), with poor prognosis (Boyes grades II–IV). The procedure included placing a silicone rod and creating a loop between the FDP and FDS in the first stage and reflecting the latter as a pedicled graft through the pseudosheath created around the silicone rod in the second stage. At a mean follow-up of 18 months (range 12–30 months), results were assessed by clinical examination and questionnaire. The mean total active motion of these fingers was 188°. The mean power grip was 80.0% and pinch grip was 76% of the contralateral hand. The rate of excellent and good results was 75% according to the Buck-Gramcko scale. These results were better than the subjective scores given by the patients. Complications included postoperative hematoma in two, infection in one, silicone synovitis in one (after stage I) and three flexion contractures after stage II. This study confirmed the usefulness of two-stage flexor tendon reconstruction using the combined technique as a salvage procedure to restore flexor tendon function with a few complications.

2017 ◽  
Vol 43 (5) ◽  
pp. 487-493 ◽  
Author(s):  
Aude Bommier ◽  
Duncan McGuire ◽  
Patrick Boyer ◽  
Asan Rafee ◽  
Sami Razali ◽  
...  

We report outcomes of reconstruction of zone 1 or 2 flexor tendon injuries using a heterodigital hemi-tendon transfer of the flexor digitorum profundus in 23 fingers of 23 patients. At mean follow-up of 57 months, the mean total active motion of the three finger joints including the metacarpophalangeal joint was 128 degrees preoperatively and 229 degrees at final follow up. According to Strickland criteria, the function was excellent for 14 fingers, good for seven fingers and poor for two fingers. The subgroup analysis showed that the results were better in cases of primary surgery, children, and for the index and little fingers. Complications included stiffness of three fingers, and rupture in one finger that was converted to a two-stage tendon reconstruction. We conclude that this technique restores good function in most patients with zone 1 and 2 flexor tendon injuries, in which primary tendon repair has not been performed or was unsuccessful, and where pulley reconstruction is not required. Level of evidence: IV


2003 ◽  
Vol 28 ◽  
pp. 53
Author(s):  
Nickolaos Darlis ◽  
A.E. Beris ◽  
A.V. Korompilias ◽  
M.D. Vekris ◽  
G.I. Mitsionis ◽  
...  

2013 ◽  
Vol 39 (1) ◽  
pp. 46-53 ◽  
Author(s):  
M. M. Al-Qattan

This review aims to highlight the differences in the management of flexor tendon injuries between children and adults. These include differences in epidemiology, anatomy, classification, diagnosis, incisions and skin closure, the size of the flexor tendons, technical aspects of zones I and II repairs, core suture purchase length, rehabilitation, results, and complications of primary flexor tendon repair. Finally, one- versus two-stage flexor tendon reconstruction in children is reviewed.


Open Medicine ◽  
2014 ◽  
Vol 10 (1) ◽  
Author(s):  
Shixin Wang ◽  
Zhenling Qiu

AbstractFlexor digitorum tendon injuries are challenging conditions to manage to ensure optimal patient outcomes. While several surgical approaches with high success rates have been developed, there remains no gold standard for suture technique for the repair of flexor tendon injuries. In this study, we compared two distinct peripheral suture methods on the strength of repaired tendons. Pig flexor digitorum profundus tendons were used in biomechanical studies and the biomechanical influence on tendon repair of continuous running peripheral suture (CRPS) and continuous locking peripheral suture (CLPS), were compared, using stitch length ranging from 1mm to 5mm. In CRPS, the 1mm stitch length group displayed the highest maximum load and breaking power, which was 1.57 fold higher than the 2mm stitch length group. Pairwise comparison revealed that the 1 and 2mm groups were statistically different from the 3, 4, and 5mm stitch length groups while comparison among the latter groups was not statistically significant. For CLPS, the 1mm group exhibited consistently the highest maximum load strength and breaking power, which was twice the strength displayed by the 2mm group. Pairwise comparisons between groups showed statistical significance. For future repairs of flexor tendon injuries, 1mm stitch length is highly recommended for simple peripheral suture.


2018 ◽  
Vol 23 (04) ◽  
pp. 487-495 ◽  
Author(s):  
Min Kai Chang ◽  
Shian Chao Tay

Background: Although flexor tendon injuries cause significant morbidities and socio-economic implications, there have been limited data on patient demographics, injury characteristics and surgical details. The aim of this study is to describe our experience in flexor tendon injuries and repairs.Methods: We performed a retrospective study of all digital flexor tendon injuries that were repaired from January 2011 to December 2014. The collected data included patient demographics, injury characteristics and surgical details.Results: A total of 214 patients, 308 digits with 446 flexor tendon repairs were identified. We found that males, non-residents, and 20–29 age group were most prone to flexor tendon injuries. Cleaners, labourers and related occupations were the most vulnerable. The mechanism of injury was usually work-related and mostly caused by glass. Most injuries involve both flexor digitorum profundus and flexor digitorum superficialis tendons. Concomitant digital nerve and vessel injuries were common. Most patients suffered zone 2 laceration of a single digit of the non-dominant hand. Most patients underwent procedures that lasted 1 to 2 hours, including multiple flexor tendon repairs, microsurgical repairs and other interventions.Conclusions: This study is the largest study on patient demographics, injury characteristics and surgical details on flexor tendon injuries and repairs. It could be used to plan resources and policies for the management and prevention of flexor tendon injuries.


2003 ◽  
Vol 28 (4) ◽  
pp. 652-660 ◽  
Author(s):  
Alexandros E Beris ◽  
Nickolaos A Darlis ◽  
Anastasios V Korompilias ◽  
Marios D Vekris ◽  
Gregory I Mitsionis ◽  
...  

1988 ◽  
Vol 13 (3) ◽  
pp. 269-272
Author(s):  
M. SINGER ◽  
S. MALOON

This study is a critical analysis of results obtained following primary repair and post-operative controlled mobilisation of flexor tendon injuries which were treated by registrars with up to six months experience in hand surgery. 70 (55%) of 125 patients who underwent repair of a complete flexor digitorum profundus or flexor pollicis longus tendon injury during a 14-month period attended for review and these had a total of 140 injured digits. 93 (67%) were rated Lister’s standards as an “excellent” or “good” result. 39 (28%) occurred in “no man’s land” (Zone 2) and only 19 (49%) in this area were rated “excellent” or “good”. Isolated flexor digitorum superficialis tendon injuries have been excluded from this study, as have partial tendon injuries.


2018 ◽  
Vol 29 (4) ◽  
pp. 407-416
Author(s):  
Yasser Youssef Abed ◽  
Khaled Ayman Nour ◽  
Moheib Saed Ahmed ◽  
Abed Abd el latif El Negery

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